New statin guidelines cheered locally

Dr. Paul Urban of Urban Cardiology, right, performs a heart catheterization on a patient with Michael Shadlich, a radiology technology/radiography/computed tomography technician, left, in one of the Cardiac Cath Labs at Ocala Regional Medical Center in Ocala on Friday.

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No wonder doctors and patients tuned in with interest this week when new guidelines for preventing cardiovascular disease were announced.

In current practice, monitoring cholesterol levels is paramount. That metric remains important, but doctors now are asked to assess risk for heart disease in a more comprehensive manner, and to perhaps prescribe cholesterol-lowering statins sooner than they might be doing now.

The American College of Cardiology and the American Heart Association authored the new guidelines, which are designed to reduce patients' risk of heart attack or stroke.

The authors ask doctors to consider prescribing statin use, designed to reduce LDL or "bad" cholesterol, for patients who fit into risk groups such as:

• Patients who already have suffered a heart attack, stroke or major symptoms of cardiovascular disease;

• Patients who have a "bad" cholesterol reading of 190 or higher;

• Diabetics;

• Patients ages 40 to 79 who face a 7.5 percent risk of having a heart attack over the next 10 years as determined by a newly revised "risk score" based on cholesterol, smoking, blood pressure and other such factors.

This comprehensive approach makes sense to Dr. John Bittl, an invasive/interventional cardiologist with Munroe Heart in Ocala.

"I'd rather see people use these preventive approaches so they don't have to come see me," said Bittl, who performs cardiac catheterization procedures and installs coronary stents.

"It (announcement of the new guidelines) is a very positive step," agreed Dr. Premranjan Singh, an interventional cardiologist with Urban Cardiology/Heart and Vascular Services.

Singh said some patients may resist going on a statin, fearing side effects such as muscle pain. But the medicines have proven benefits, and patients also can make lifestyle changes in diet and exercise.

They could get themselves to a point, perhaps, where statin use could be revisited.

Singh said these new guidelines will be an adjustment for primary care physicians as well as their patients. The key, he said, is that the positive effects of statins be recognized and, where appropriate, the medicine be put to use — even if that's sooner than some people might be accustomed to.

The guidelines are of particular interest in a county like Marion, where 26 percent of the population is age 65 or older and the adult population overall has some troubling health metrics: 22 percent of adults smoke, 32 percent are characterized as obese and 13 percent are diabetics.

Of Florida's 67 counties, Marion ranked 44th for mortality and morbidity rates and 39th in other health-related behavior in the latest report from the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.

Andy Pietrzyk, 70, of Ocala Palms, has been taking a statin for the past 10 years to address high cholesterol.

"They've been very effective for me," he said. "I haven't had any (negative side effects) at all."

Pietrzyk said it would be a good thing if these new guidelines resulted in doctors and patients having a conversation about these cardiovascular issues sooner than they otherwise might.

He didn't start statin use until he started getting checkups through the federal health system for veterans.

In hindsight, "I could have gone on them (statins) sooner," he said. He has a physical and blood work every nine months now.

According to the Associated Press, if the new statin guidelines are fully implemented, 33 million Americans would qualify for usage. That's double the number now meeting the threshold.

Increased prescriptions would not pose a logistical problem, according to Melissa Hughes, a pharmacist at Belleview Community Pharmacy.

Statins, in brand-name and generic forms, are high-volume products and well known within the pharmacy community. Also, availability is not an issue.

Plus, "most insurance (plans) pay for them and the generics are inexpensive," Hughes said.

Contact Jim Ross at 671-6412 or jim.ross@ocala.com. Follow him on Twitter @jimross96.

<p>Heart disease caused 24 percent of all deaths in Marion County last year. The percentage was about the same for the past five years, and it mirrors the national picture.</p><p>No wonder doctors and patients tuned in with interest this week when new guidelines for preventing cardiovascular disease were announced.</p><p>In current practice, monitoring cholesterol levels is paramount. That metric remains important, but doctors now are asked to assess risk for heart disease in a more comprehensive manner, and to perhaps prescribe cholesterol-lowering statins sooner than they might be doing now.</p><p>The American College of Cardiology and the American Heart Association authored the new guidelines, which are designed to reduce patients' risk of heart attack or stroke.</p><p>The authors ask doctors to consider prescribing statin use, designed to reduce LDL or "bad" cholesterol, for patients who fit into risk groups such as:</p><p>• Patients who already have suffered a heart attack, stroke or major symptoms of cardiovascular disease;</p><p>• Patients who have a "bad" cholesterol reading of 190 or higher;</p><p>• Diabetics;</p><p>• Patients ages 40 to 79 who face a 7.5 percent risk of having a heart attack over the next 10 years as determined by a newly revised "risk score" based on cholesterol, smoking, blood pressure and other such factors.</p><p>This comprehensive approach makes sense to Dr. John Bittl, an invasive/interventional cardiologist with Munroe Heart in Ocala.</p><p>It's "treating the patient, not treating a number," he said.</p><p>And, of course, lifestyle modifications — a better diet, increased exercise — are always encouraged.</p><p>"I'd rather see people use these preventive approaches so they don't have to come see me," said Bittl, who performs cardiac catheterization procedures and installs coronary stents.</p><p>"It (announcement of the new guidelines) is a very positive step," agreed Dr. Premranjan Singh, an interventional cardiologist with Urban Cardiology/Heart and Vascular Services.</p><p>Singh said some patients may resist going on a statin, fearing side effects such as muscle pain. But the medicines have proven benefits, and patients also can make lifestyle changes in diet and exercise.</p><p>They could get themselves to a point, perhaps, where statin use could be revisited.</p><p>Singh said these new guidelines will be an adjustment for primary care physicians as well as their patients. The key, he said, is that the positive effects of statins be recognized and, where appropriate, the medicine be put to use — even if that's sooner than some people might be accustomed to.</p><p>The guidelines are of particular interest in a county like Marion, where 26 percent of the population is age 65 or older and the adult population overall has some troubling health metrics: 22 percent of adults smoke, 32 percent are characterized as obese and 13 percent are diabetics.</p><p>Of Florida's 67 counties, Marion ranked 44th for mortality and morbidity rates and 39th in other health-related behavior in the latest report from the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.</p><p>Andy Pietrzyk, 70, of Ocala Palms, has been taking a statin for the past 10 years to address high cholesterol.</p><p>"They've been very effective for me," he said. "I haven't had any (negative side effects) at all."</p><p>Pietrzyk said it would be a good thing if these new guidelines resulted in doctors and patients having a conversation about these cardiovascular issues sooner than they otherwise might.</p><p>He didn't start statin use until he started getting checkups through the federal health system for veterans.</p><p>In hindsight, "I could have gone on them (statins) sooner," he said. He has a physical and blood work every nine months now.</p><p>According to the Associated Press, if the new statin guidelines are fully implemented, 33 million Americans would qualify for usage. That's double the number now meeting the threshold.</p><p>Increased prescriptions would not pose a logistical problem, according to Melissa Hughes, a pharmacist at Belleview Community Pharmacy.</p><p>Statins, in brand-name and generic forms, are high-volume products and well known within the pharmacy community. Also, availability is not an issue.</p><p>Plus, "most insurance (plans) pay for them and the generics are inexpensive," Hughes said.</p><p><i>Contact Jim Ross at 671-6412 or jim.ross@ocala.com. Follow him on Twitter @jimross96.</i></p>